Understanding Autism Spectrum Disorders
Autism is not a single disorder, but a spectrum of closely related disorders with a shared core of symptoms. Every individual on the autism spectrum has problems to some degree with social interaction, empathy, communication, and flexible behavior. But the level of disability and the combination of symptoms varies tremendously from person to person. In fact, two kids with the same diagnosis may look very different when it comes to their behaviors and abilities.
If youre a parent dealing with a child on the autism spectrum, you may hear many different terms including high-functioning autism, atypical autism, autism spectrum disorder, and pervasive developmental disorder. These terms can be confusing, not only because there are so many, but because doctors, therapists, and other parents may use them in dissimilar ways.
But no matter what doctors, teachers, and other specialists call the autism spectrum disorder, its your childs unique needs that are truly important. No diagnostic label can tell you exactly what challenges your child will have. Finding treatment that addresses your childs needs, rather than focusing on what to call the problem, is the most helpful thing you can do. You dont need a diagnosis to start getting help for your childs symptoms.
Whats in a name?
Social Communication And Social Interaction Challenges
Autistic people have difficulties with interpreting both verbal and non-verbal language like gestures or tone of voice. Some autistic people are unable to speak or have limited speech while;other autistic people have very good language skills but struggle to understand sarcasm or tone of voice. Other challenges include:
- taking things literally and not understanding abstract concepts
- needing extra time to process information or answer questions
- repeating what others say to them
Autistic people often have difficulty ‘reading’ other people – recognising or understanding others’ feelings and intentions – and expressing their own emotions. This can make it very hard to navigate the social world. Autistic people may:
- appear to be insensitive
- seek out time alone when overloaded by other people
- not seek comfort from other people
- appear to behave ‘strangely’ or in a way thought to be socially inappropriate
- find it hard to form friendships.
The Importance Of The Autism Caregiver
Caregivers also need to understand how important they are. Both Berman and Shore give a lot of credit to their parents for their tenacity and dedication. In the early 1960s, experts told Shoreâs parents that their sonâs autism symptoms were so severe that his case was hopeless and he needed to be institutionalized. But his parents defied the experts and kept fighting, and they were right.
McGreevy is a passionate advocate for her son too. While she tries to accommodate his autism symptoms and keep a home environment in which he feels safe, sheâs also working constantly to expand his horizons. âI think because of his condition, my son would be fine being stagnant,â she tells WebMD. âIf heâs going to experience new things and grow and take the next step, I need to push him.â
For a caregiver, empathy is key. Just forcing a person with autism into the âreal worldâ wonât work. Instead, the first step is to try to understand their perspective a little better.
âAs a parent or caregiver, you need to go into the world of the person with autism first,â says Shore. âThen you can start guiding that person out.â
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How Can I Help A Friend With Autism
People with ASD have a very wide array of signs and symptoms. Some people with ASD do not feel that they have a disorder and don’t want to change. They’re proud of who they are and they want to be accepted, even though they may have different strengths and weaknesses than most other people.
All people deserve respect. But people with ASD may be teased, bullied, or left out because they’re different. Bullying and teasing are never the right way to treat other people, but it may be hard to be a friend with someone who has ASD.
People with ASD often don’t understand playful jokes or sarcasm. You may need to be very clear and factual when you communicate with someone who has ASD.
Try to be patient and kind. Remember how hard it might be for the person with ASD to understand how to be a friend. Stand up for classmates who are bullied. Tell adults, so they can help protect kids who are bullied.
Causes And Risk Factors
We do not know all of the causes of ASD. However, we have learned that there are likely many causes for multiple types of ASD. There may be many different factors that make a child more likely to have an ASD, including environmental, biologic and genetic factors.
- Most scientists agree that genes are one of the risk factors that can make a person more likely to develop ASD.4, 19
- Children who have a sibling with ASD are at a higher risk of also having ASD. 5-10
- Individuals with certain genetic or chromosomal conditions, such as fragile X syndrome or tuberous sclerosis, can have a greater chance of having ASD. 11-14, 20
- When taken during pregnancy, the prescription drugs valproic acid and thalidomide have been linked with a higher risk of ASD.15-16
- There is some evidence that the critical period for developing ASD occurs before, during, and immediately after birth. 17
- Children born to older parents are at greater risk for having ASD. 18
ASD continues to be an important public health concern. Like the many families living with ASD, CDC wants to find out what causes the disorder. Understanding the factors that make a person more likely to develop ASD will help us learn more about the causes. We are currently working on one of the largest U.S. studies to date, called Study to Explore Early Development . SEED is looking at many possible risk factors for ASD, including genetic, environmental, pregnancy, and behavioral factors.
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How Does Autism Affect Adults
Families who have autistic loved ones may worry about what life with ASD looks like for an adult.
Some autistic adults go on to live or work independently. Others may require continued aid or support throughout their lives. Each autistic person is different.
Introducing therapies and other remedies early in life can help lead to more independence and better quality of life.
Sometimes autistic people dont receive a diagnosis until much later in life. This is due, in part, to a previous lack of awareness among medical practitioners.
Autism Symptoms In Adults At Home
Other peoples feelings baffle you. You have a collection of figurines on your desk that must be in the same order at all times. These, and other common manifestations of ASD, may be apparent in adults at home:
- Your family members lovingly refer to you as the eccentric professor of the family, even though you dont work in academia.
- Youve always wanted a best friend, but never found one.
- You often invent your own words and expressions to describe things.
- Even when youre in a quiet place, like the library, you find yourself making involuntary noises like clearing your throat over and over.
- You follow the same schedule every day of the week, and dont like unexpected events.
- Expressions like, Curiosity killed the cat or Dont count your chickens before they hatch are confusing to you.
- You are always bumping into things and tripping over your own feet.
- In your leisure time, you prefer to play individual games and sports, like golf, where everyone works for themselves instead of working toward a common goal on a team.
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When The Mild Autism Term Is Used
So, what does a practitioner, teacher, or parent mean when they say a child has mild autism? Since there is no official definition of the term, every person using it has a slightly different idea of what it means.
Sometimes the term is used when an individual is clearly autistic, but also has significant spoken language and other skills. The term may also be used to help explain treatment decisions.
Furthermore, a person with “mild autism” may have advanced communication skills and academic abilities, but have very delayed social skills, severe sensory issues, and/or extreme difficulties with organizational skills . If and when these manifest may also depend on the specific environment or situation.
Signs Of Autism Meltdown
For some people with autism, sensory overload can become overwhelming. In these situations a person may have a meltdown. A change in routine can also precipitate a meltdown.
A meltdown is not a temper tantrum and can be experienced by someone with autism of any age. A meltdown should be managed by calming the person and addressing the cause of the distress.
Signs that a meltdown may be developing, sometimes known as the rumbling stage, include:
- Nail biting
- Chronic gastritis
- Chronic duodenitis
Many people with autism spectrum disorder also have food intolerances and may find that a diet which excludes gluten or casein helps.
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Why Seek Diagnosis Or Identify As Autistic
A quarter of a century later, we know that the presence of autistic traits does not necessarily mean that a person needs support or a diagnosis. But, for the majority of autistic people, a diagnosis can be very beneficial, and not only because books like the DSM 5 act as gatekeepers for services and support.
All autistic people benefit from supportive and structured educational approaches that take into consideration their shared characteristics, regardless of where they may happen to be on the spectrum.
What Are The Symptoms Of Autism Spectrum Disorder
Children with autism often show symptoms before they are two years old. Some children begin to lose language or social skills at the age of one or two. Autism looks different in each child. Not every child shows every symptom, and some have more severe symptoms.
Symptoms of ASD are grouped into two categories:
Social Communication and Social Interaction
- Doesnt like to cuddle or hug
- Likes to play alone
- Hasnt spoken a word by 18 months
- Cannot say two-word phrases by two years old
- Speaks differently than other children:
- Sounds like a robot when speaking
- Speaks in a very singsong way
- Repeats phrases or puts words in the wrong order
- Can recite information but not use it to solve problems or have a conversation
- Rarely or never makes eye contact
- Has trouble carrying on a conversation and letting the other person talk
- Repeats the same action over and over again
- Focuses on small details and nothing else
- Struggles with changes in their routine
- Puts toys in order instead of playing with them
- Gets extremely focused on specific topics or objects
Additionally, children with autism are often sensitive to sounds, lights, textures or smells. This is called asensory processing problem. For example, loud noises or bright lights can make them very uncomfortable. Or, they may need more sensations to feel comfortable, so they will try to bump into things or constantly touch or smell things.
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Levels Of Autism From A Less Neurotypical Perspective
I’d like to share something I came across a good while ago. Though I’ve been able to locate it on the web, I’m not quite sure of its original source. It goes something like this :
“I know an autistic person who can typically make eye contact, understand body language, and understand sarcasm, while not having a lot of meltdowns and keeping their ‘stims’ to themselves. This person would be considered high-functioning. I also know an autistic person who gets overloaded in public places, often can’t stand to be touched, go to the store alone, or switch from one activity to another. They might also forget to shower or eat. This person would be considered low-functioning. Guess what? They’re both me.”
Autistic people aren’t the only ones who suggest that this classification system is no good, mind you; some researchers argue against it as well.;
- American Psychiatric Association. . Diagnostic and statistical manual of mental disorders . Arlington, VA: American Psychiatric Association.
Autism Is More Than A Single Disorder
- Making little to no eye contact
- Delays in or lack of spoken language
- Repetitive use of language, unusual movements or repetitive behavior with objects
- Lack of interest in making friends or in interacting socially with family
- Unusual fixation on specific objects or topics
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Repetitive Or Restrictive Behaviors
An autistic child who has adopted certain repetitive or restrictive behaviors may exhibit some of these signs:
- performs repetitive motions, such as flapping their hands, rocking back and forth, or spinning
- persistently or repeatedly lines up toys or other objects in an organized fashion
- gets upset or frustrated by small changes in their daily routine
- has to follow certain routines
- plays with toys the same way every time
- likes certain parts of objects
- has obsessive interests
Challenging Behaviors In Autism
People with autism spectrum disorder may exhibit behaviors which put themselves at risk, cause difficulties for people around them or which are not socially acceptable.
Around 50 percent of people with autism engage in behavior that can cause themselves harm when they feel frustrated, overwhelmed or unwell. Such behaviors can include:
- Banging their head on walls or other objects
- Hitting themselves, e.g. hitting their head with their hands
- Poking themselves in the eye
- Pulling their hair
- Biting themselves
- Smearing feces
A person with autism who feels frustrated, overwhelmed or feeling unwell may also display physically aggressive behavior. This can include:
- Throwing objects
- Hitting, slapping or biting other people
- Pulling other peopleÃ¢â¬â¢s hair
Some people with autism eat objects that are not edible, or keep the objects in their mouth, a behavior known as pica. It is the most common eating disorder found in people with autism spectrum disorder. People may eat anything, including dirt or soap.
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How Is Asd Diagnosed
ASD symptoms can vary greatly from person to person depending on the severity of the disorder. Symptoms may even go unrecognized for young children who have mild ASD or less debilitating handicaps.
Autism spectrum disorder is diagnosed by clinicians based on symptoms, signs, and testing according to the Diagnostic and Statistical Manual of Mental Disorders-V, a guide created by the American Psychiatric Association used to diagnose mental disorders. Children should be screened for developmental delays during periodic checkups and specifically for autism at 18- and 24-month well-child visits.
Very early indicators that require evaluation by an expert include:
- no babbling or pointing by age 1
- no single words by age 16 months or two-word phrases by age 2
- no response to name
- excessive lining up of toys or objects
- no smiling or social responsiveness
Later indicators include:
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What Autistic People Have To Say
Through our Stories from the Spectrum series, weve spoken to several autistic people, who have shared their thoughts on this topic, what being autistic is like for them, and some of the positive aspects of being autistic.
I just seem to see and think about people and the world in a different way. Its part of who I am. John Clark
John Clark, autistic filmmaker, told us:I just seem to see and think about people and the world in a different way. For instance, I am both confused and fascinated by idioms. Its part of who I am. I used to be very self-conscious about people liking and accepting me, but now, I just think, take me or leave me. Were all different. Some people seem to find live and let live a difficult mantra to grasp though.
Patrick Samuel, autistic artist and musician, said: My autism;makes it easy for me to do things a lot of non-autistic people may struggle with. I work intensely when Im painting, writing, composing or doing anything creative. I think being autistic also contributes to my aptitude in problem solving and pattern recognition, which can help me research a highly specialised subject and give talks on it.
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Level : Requiring Very Substantial Support
Level 3 is the most severe form of autism. Children in this category will manifest many of the same behaviors as those with levels 1 and 2, but to a more extreme degree.
Problems expressing themselves both verbally and nonverbally can make it very hard to function, interact socially, and deal with a change in focus or location. Engaging in repetitive behaviors is another symptom of level 3 ASD.
A person with ASD level 3 will have a very limited ability to speak intelligibly and will rarely initiate interactions. When they do initiate an interaction, they will do so awkwardly. Someone with level 3 will also respond only to very direct social approaches from other people.